Scalpel

A scalpel is a small and extremely sharp bladed
instrument used for
surgery, anatomical
dissection, and various
arts and crafts. Scalpels may be disposable or re-usable,
re-usable scalpels can have attached, resharpenable blades or,
more commonly, non-attached, replaceable blades. Disposable
scalpels usually have a plastic handle with an extensible blade
(like a
utility knife) and are used once, then the entire instrument
discarded. Double-edged scalpels are referred to as "lancets".

Surgical
scalpels

Surgical scalpels consist of two parts, a blade and a handle.
The handles are reusable, with the blades being replaceable. In
medical applications, each blade is only used once (even if just
for a single, small cut). Medical scalpel handles come in two
basic types. The first is a flat handle used in the #3 and #4
handles. The #7 handle is more like a long writing pen, rounded
at the front and flat at the back. A #4 handle is larger than a
#3, and while some blades fit both others are too large or small
and can only fit one or the other. The following table of blades
is incomplete and some blades listed may work with handles not
specified here.

Types of surgical scalpel blades

Blade No.

Compatible Handles

Blade Description

Uses

#10

1, 3, 7

Curved cutting edge with flat back

For cutting skin and muscle in surgery, and for
general carving and
stencil making; also can be used for removal of
'edge beads' from photolithography resists.

#10a

3, 3L, 3 Graduated, 5B, 7, 9, B3, B3L

This blade is a small and straight

#11

1, 3, 7

Triangular blade with sharp point, flat cutting edge
parallel to the handle and flat back

For precision cutting, stripping, sharp angle cuts
and also
stencil cutting due to its similarity to the X-Acto
artknife blade

#12a

3, 7

A small, pointed, crescent-shaped blade sharpened on
the inside edge of the curve

#12b

3, 7

A small, pointed, crescent-shaped blade sharpened on
both sides of the curve

#15

3, 7

A smaller version of the #10

For the same general uses as the #10 blade

#15c

3, 7

The #15 with a downward angle, flatter and thinner
than the #15

#16

1, 3

A narrow chisel-like blade with flat, angled cutting
edge, positioned higher than the axis of the handle

For cutting stencils, scoring and etching

#17

1, 3

A flat face 1.6 mm chisel blade

For narrow cuts

#18

2, 5, 6

A 12.7 mm chisel blade

For deep cuts and scraping

#19

4

A similar blade to the #15

#22

2, 4, 5, 6

A larger version of the #10

For general use, shaping, whittling and trimming

#24

2, 5, 6

A wide, flat, angled cutting edge

For corner cuts, trimming, stripping, and cutting
mats and gaskets

#25

4

A triangular blade similar to the #11, with the flat
back edge taking a downwards angle

#60

4

A long blade resembling the #10 with a long cutting
edge, rounded tip and flat back.

Gripping a medical scalpel

Palmar grip

Also called the "dinner knife" grip. The handle is held with
the second through fourth fingers and secured along the base of
the thumb, with the index finger extended along the top rear of
the blade and the thumb along the side of the handle. This grip
is best for initial incisions and larger cuts.

Pencil grip

Best used for more precise cuts with smaller blades (e.g.
#15) and the #7 handle. The scalpel is held with the tips of the
first and second fingers and the tip of the thumb with the
handle resting on the fleshy base of the index finger and thumb.
Care should be taken not to allow the handle to rest too far
along the index finger as this promotes an unstable grip and
cramped fingers. This is widely considered the non-standard grip
by the medical professionals, despite its more practical usage.[citation
needed]

Graphic design and arts and crafts blades

X-Acto knife

Graphical and model-making scalpels tend to have round
handles, with textured grips (either
knurled metal or soft plastic). These are often called by
the name of the most well-known manufacturer of graphic arts
blades,
X-Acto knives. The blade is usually flat and straight,
allowing it to be run easily against a
straightedge to produce straight cuts.

There are many kinds of graphic arts blades, the most common
around the graphic design studio is the #11 blade which is very
similar to a #11 surgical blade (q.v.). Other blade shapes are
used for
wood carving, cutting leather and heavy fabric, etc.

Ancient scalpels

Ancient Egyptians made incisions for embalming with
scalpels of sharpened
obsidian, a material that is still sometimes used in
modern times.

Scalpel Injuries

In the last decade, a rising awareness of the dangers of
sharps in a medical environment has led to the development of
various methods of protecting healthcare workers from accidental
cuts and puncture wounds. According to the
Centers for Disease Control and Prevention, as many as 1,000
people each day are subject to accidental needle sticks and
lacerations while providing medical care. Scalpel blade injuries
are among the most frequent sharps injuries, second only to
needlesticks. Scalpel injuries make up 7 percent to 8 percent of
all sharps injuries.[1][2]

"Scalpel Safety" is a term coined to inform users that there
are choices available to them to ensure their protection from
this common sharps injury.[3]

Safety Scalpels

Safety Scalpels are becoming increasingly popular as their
prices come down and also on account of legislation such as the
Needle Stick Prevention Act. There are essentially two kinds of
disposable safety scalpels offered by various manufacturers.
They can be either classified as retractable blade or
retractable sheath type. The retractable blade version made by
companies such as
DeRoyal,
Jai Surgicals,
Swann Morton are more intuitive to use due to their
similarities to a standard box-cutter. On the other hand,
retractable blade versions are not as precise because the blade
tends to wobble. Retractable sheath versions made by companies
such as
Aditya Dispomed,
Becton Dickinson and
Personna offer greater stability, ergonomic feel, strength
and balance. Few Companies have also started to offer a safety
scalpel with a reusable metal handle. In such models, the blade
is usually protected in a cartridge. Such systems usually
require a custom handle and the price of blades and cartridges
is considerably more than for conventional surgical blades.

However, CDC studies shows that up to 87% of active medical
devices are not activated. Safety scalpels are active devices
and therefore the risk of not activating is still significant.
[4]
There is a study that indicated there were actually four times
more injuries with safety scalpels than reusable scalpels.[5]

Scalpel
Blade Removers

There are various scalpel blade removers on the market that
allows users to safety remove blades from the handle, instead of
dangerously using fingers or forceps. In the medical field, when
taking into account activation rates, the combination of a
single-handed scalpel blade remover with a passing tray or a
neutral zone was as safe and up to five times safer than a
safety scalpel.[6]
Companies like
Qlicksmart offers a single-handed scalpel blade remover that
complies with regulatory requirements such as US OSHA Standards.[7]

Scalpel Safety

The usage of both safety scalpels and a single-handed blade
remover combined with a hands-free passing technique are
potentially effective in reducing scalpel blade injuries.
[6]
It is up to employers and scalpel users to consider and use
safer and more effective scalpel safety measures when feasible.